Managing the Inevitability of Change

Sarah Mensa-Kwao Cook is an RN at Memorial Regional Hospital and Holy Cross, and has served in capacities of charge nurse and preceptor. She holds multiple bachelor degrees in Bio-medical Physics and Nursing, and volunteers as a mentor with The McDougle Family Foundation and Broward Fellowship of Christian Athletes (FCA). Her primary focus is in cardio-pulmonary and neurology, where she specializes in telemetry.

Abstract

There is a predictable eventuality of change in the workplace. Some of the more extreme kinds include the shutting down of a unit. A survey study conducted on one of the leading south Florida hospital unit reveals a range in emotions of staff reaction to the unit closing. Since change in most instants is associated with negative feels such as fear, confusion, and sadness, mitigating the level of negative feelings aids in a successful transition. Through the utilization of effective communication, highlighting all the opportunity it affords the affected employees, and employee participation in decision making process through feedback, as seen in the management process, has helped in keeping the staff focused on the positives.

Key Words: Change in the workplace, closing of a unit, emotional impact of change, employee satisfaction

Change is inevitable. Whether we are changing our minds, our clothes, or a channel on television, we know change happens… and we are fine with it, when we are the ones enacting it. However, what about when change happens to us? This article explores the effects of a hospital’s unit closing on staff – the good, the bad, and the ugly – and seeks to identify ways to mitigate the bad and ugly emotional responses, and hopefully explore means of increasing the good (by both hospital management practice, and individual mindset). A unit in one of south Florida leading hospital serves as a case study as we delve into this topic.

With respect to organizational change in the general sense, Cynthia Wittig writes that “change agents focusing on employee reactions—including resistance and acceptance—during organizational change are of utmost importance to the success of the initiative” (Wittig, p.24). What this means is that whatever the reasons for a unit closing, for this move to prove successful, outside of a sound strategy, positive employee reaction/feeling is necessary.

In a recent survey study on a south Florida hospital’s unit staff, the range in emotions about the closing of this unit was expansive. With outliers of depressed and elated, the central standard deviations of emotion ran from sadness and disappointment to cautious optimism. For those that saw the glass as half full, the optimistic tenor centered around the idea of learning a new skill, or the opportunity to move to a desired unit.

Unfortunately, many of those individual affected by the unit closing, felt sadness and confusion. One employee felt scared of starting over and having to meet new people again. Another stated an initial concern over having enough staff to cover patients during the transition. Finally, the common sentiment was one of feeling like a nomad – that they would merely be in a building with no home.

In a service-oriented, patient-driven industry, it is an absolute must that employees have the proper disposition to administer the type of care necessary to treat the sick, and keep the hospitals from closing. Having a sense of helplessness, isolation, sadness, uncertainty, and depression are recipes for disaster, and certainly undermine any rationale for the floor closing.

There is something that can be done to mitigate the level of negative feelings towards the changes in the workplace. First, the effective communication of the decision to close the floor, highlighting all the opportunity it affords the affected employees, certainly helps to keep their focus on the positives. Another tactic that “strongly impacts employees’ reac¬tions is employee participation in decision making (PDM). PDM is a process in which influence or decision making is shared between superiors and their subordinates” (Bordia, p. 512). Even if not substantive, merely the appearance of a say-so in a major decision within an organization lends to the “employees’ perceptions of fairness, which is vital for acceptance of change and commitment to organizational goals” (Bordia, p. 513).

Short of even the appearance of inclusion, providing a mechanism for feedback from employees goes a long way towards reducing the amount of venting that could occur. “Venting is perceived as dysfunctional for anger coping and therefore also for individual well-being.” The built-up feelings of anger, resentment, and frustration, without a proper release avenue is like hydrocephalus without a shunt – it could merely be a headache, but could also lead to much worse. Complaining from disgruntled employees only begets more complaining. “In the context of organizational change, venting is appraised as dysfunctional change behavior.” In this vein, there is a positive correlation between venting and a disruptive resistance to change (Bönigk & Steffgen, p. 6219).

“RAP sessions” held by hospital administration on this south Florida hospital’s unit served as the metaphorical shunt for frustrated/confused employees, allowing the outward expressions a release valve turning potential venting into substantive feedback. Unlike venting, feedback is considered an “expressive form of anger reaction and characterized as ‘constructive’, as a manner to directly influence and change anger evoking conditions that also positively influence physiological arousal.” (Bönigk & Steffgen, 2013). Allowing for some form of feedback can take on the appearance of PDM, eliciting a positive response from employees.

Fortunately, this south Florida hospital’s management did a tremendous job instituting some of these best practices, and many of the initial feelings of fear, anger, and apprehension gave way to those of hope, anticipation, and encouragement. In a follow-up survey, these staffers on the hospital unit began to understand that with the closing of this unit’s doors, came the opening of others. Their feelings of objection yielded to opportunity. Like Thomas Fuller, they realized “it is always the darkest before the dawn.” So, if you’re in a midst of a major change in your organization, don’t get too concerned over initial feelings of worry, know that they’ll subside and potential is on the horizon. Or to get Biblical, while “weeping may endure for a night, joy comes in the morning.”